But the promise that
technology would provide the great leap forward has not yet been fully realized.
Hunt Blair, the state's health information technology coordinator, told the
oversight committee that Vermont
was an early adopter of electronic medical records.

"We are on the bleeding edge,"
he says. "The bleeding edge. We are paying the price for being out in front and
trying to move this forward."

Blair says some of the computer
systems that were put in place in the early years have encountered
technological bugs, including the inability to exchange data across different platforms.
Blair faults the federal government for not coming up with strong standards to
ensure that the various programs that hospitals and physicians use can actually
talk to each other.

"For instance, in a simple a
thing as recording blood pressure some systems record it as a text, some as
numbers," he says. "That's where the problems begin, when you have one system
that keeps something as an integer and another as text it gets very hard to
merge that data together without lots of translation steps."

Blair didn't cite any
specific patient care issues. But the problems are frustrating to Rutland Senator
Kevin Mullin, a member of the Health Access Oversight Committee.

"Providers are frustrated.
They're looking at health records that are not accurate or complete," he says. "So
they're not useful. And it's just a mess, and this needs to be cleaned up."

Mullin says that many of
these problems were anticipated in 2006 when the systems were first designed.

"And here we are six years
later and now fingers are being pointed at the feds, although the feds try to point
to Vermont as being leaders in technology," Mullin says. "Well if we're the
leaders why aren't we having the conversations with the feds and saying: ‘look
these systems have to be inter-operable; they have to communicate with each
other.'"

State officials say they are
pushing back to the federal government with exactly those kinds of concerns.

Mark Larson is a former
lawmaker and now commissioner of health access in the Shumlin Administration.
He told the oversight panel that he sees progress in the fact that the state
can now identify the problems in health IT.

"In the past we had no
systems and therefore they didn't talk to each other. Now we actually have
systems and we find they're not sharing the information as effectively as we
want them to," he says. "That is a sign of progress from where we started. It's
an unfortunate step along the way that we get to this point and we have to
figure out now that we have these things why the hell aren't they working the
way we want."

The stakes for the taxpayer
are huge. The state and federal government are investing about $79 million in
fiscal years 2012 and 2013 to improve health information technology.